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目的:比较治疗耳硬化症不同术式的疗效。方法:回顾性分析1993~2005年行手术治疗且资料完整的耳硬化症患者70例(76耳)的临床资料,按术式分为3组:镫骨全切除术30例(33耳),足板小孔开窗术24例(27耳)和镫骨撼动或提高术16例(16耳),统计3组患者术后各频率段气骨导差闭合、骨导损失及眩晕发生率等指标,比较3种术式间的差异,同时比较镫骨撼动术5例(5耳)与镫骨提高术11例(11耳)2组手术亚型间的疗效差异。结果:3种术式术后言语频率气骨导差闭合无明显差异,但在高频气骨导差改善及减少术后高频感音神经性听力损失和眩晕方面,足板小孔开窗术和镫骨撼动或提高术明显优于镫骨全切除术,并有统计学意义。镫骨撼动术与镫骨提高术无论在听力改善或术后并发症发生率方面差异均无统计学意义。结论:3种术式在提高耳硬化症患者的听力方面均具有较好的疗效,其中以足板小孔开窗术疗效最佳,其次是镫骨撼动或提高术,并且在减少术后并发症方面均优于镫骨全切除术。足板小孔开窗术是治疗耳硬化症较理想的术式。
Objective: To compare the efficacy of different surgical procedures for the treatment of otosclerosis. Methods: The clinical data of 70 cases (76 ears) with surgically-treated and data-complete otosclerosis from 1993 to 2005 were retrospectively analyzed. Thirty patients (33 ears) were treated by total resection of the stapes. Twenty-four cases (27 ears) and seventeen ears (16 ears) were mobilized or raised by stapes fenestration. The incidence of tracheal anastomosis, loss of osteoconduction and vertigo The differences between the three surgical procedures were compared. The differences in the surgical subtypes of the two groups were compared between 5 cases (5 ears) of stapes fixation and 11 cases (11 ears) of stapes improvement. Results: There was no significant difference in speech frequency and air conduction between the three kinds of operation. However, in terms of improvement of high-frequency air-conduction and reduction of high-frequency sensorineural hearing loss and dizziness, Surgery and tarsal vibration or improve surgery was significantly better than tarsal total resection, and have statistical significance. Stapes and tarsal osteotomy improved in both hearing improvement or postoperative complication rate differences were not statistically significant. CONCLUSION: The three kinds of operation have better curative effect in improving hearing ability of patients with otosclerosis, of which the most effective method is to use fenestration of the foot plate, followed by tarsal osseous vibration or surgery, and in reducing postoperative complications Disease are better than the total tarsal resection. Podiatric fenestration is the ideal treatment for otosclerosis surgery.